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PubMed1990

Aerosols for systemic treatment.

The development of a new group of drugs (polypeptides) have recently increased the interest of alternative administration to the enteral route because of its proteolytic activity and the catabolism of the "first-pass effect." Aside from the "needle," the administration in the respiratory tract via aerosol is the method with the best efficiency. But several problems prohibited its spreading: (1) the accuracy and the reproducibility of the inhaled dose (range ca. 1:4); (2) the small amount of inhaled drug in relation to the dose in the aerosol delivery system (range ca. 1%-10%); (3) the fear of allergic reactions of the respiratory system; (4) the variability of the drug transport into the systemic circulation. New approaches and data raise hopes in reducing the problems: (1) aerosol delivery systems with defined particle spectrum and storage systems; slow vital capacity inhaling maneuver; (2) delivery systems that nebulizes nearly the total amount of drug; (3) all studies with the inhalation application of insulin, heparin, ergotamin, ribavirin, aminoglycosides, and "cigarette smoke" do not reveal any relevant allergic reaction; (4) many studies were performed in the last 10 years on the influence of substances and especially of diseases on the transport of molecules through the respiratory tract. Only a few of them are relevant (exogen allergic alveolitis, active sarcoidosis, active smoking). Aerosols for (exogen allergic alveolitis, active sarcoidosis, active smoking). Aerosols for systemic drug treatment seems to be a gained alternative to the "syringe."

Aerosols↗
PubMed2002

Technetium-99m-DTPA aerosol scintigraphy in amiodarone induced pulmonary toxicity in comparison with Ga-67 scintigraphy.

Amiodarone hydrochloride, which is used in life-threatening cardiac tachyarrhythmia, has been known to cause amiodarone induced pulmonary toxicity (AIPT) as a complication. In this study we aimed to investigate the clinical value of technetium-99m diethylene triamine penta-acetic acid (DTPA) aerosol lung scintigraphy in patients with AIPT in comparison with gallium-67 (Ga-67) scan. The study group included 26 cases, 7 patients with diagnosis of AIPT (Group A), 8 patients receiving amiodarone therapy but without AIPT (Group B) and 11 healthy subjects as a control group (Group C). All patients underwent Ga-67 and Tc-99m-DTPA aerosol scintigraphy in addition to various laboratory tests, Ga-67 scintigraphy was positive in 4 of 7 AIPT patients but quite normal in Group B. A positive correlation was found (r = 0.52, p < 0.05) between kep values determined by Tc-99m-DTPA aerosol scintigraphy and the cumulative dose of amiodarone. The mean kep values were 2.04% +/- 0.85%/min, 1.30% +/- 0.42%/min and 0.86% +/- 0.19%/min for groups A, B and C, respectively. The mean clearance rate of group A was significantly faster than that of normals (p < 0.0005) and group B (p = 0.028). In addition, there was a significant difference between groups B and C (p = 0.015). In conclusion, Ga-67 lung scintigraphy is a useful method for the detection of AIPT but Tc-99m-DTPA aerosol scintigraphy offers better results than Ga-67 scintigraphy. Early changes in Tc-99m-DTPA clearance may be observed in patients receiving amiodarone. The kep value in patients with AIPT is noticeably increased with respect to the control group. With its favorable physical properties, low cost, lower radiation burden and its ability to be used as an objective measure for the pulmonary clearance rate, Tc-99m-DTPA aerosol scintigraphy appears to be promising in patients receiving amiodarone therapy.

Administration, Inhalation↗
PubMed2000

Inhaled aerosolization of all-trans-retinoic acid for targeted pulmonary delivery.

Retinoids have shown promising activity for both cancer chemoprevention and as a treatment for emphysema. However, chronic oral administration of these drugs is limited by systemic side effects, including hepatic dysfunction, skeletal malformations, hyperlipidemia. hypercalcemia, and other reactions. In order to improve the pulmonary targeting of this potentially useful therapy, we developed a system for aerosolization of retinoids that substantially increased their local bioavailability. We compared the biodistribution and pharmacokinetics of an inhaled formulation of all-trans-retinoic acid (all-trans-RA), which was packaged in a metered dose inhaler, following both intratracheal (IT) and intravenous (IV) administration in male Sprague-Dawley rats. After drug administration, anesthetized animals were killed at 5 min, and at 1, 2, 4, 6 and 24 h. Plasma and emulsified samples of liver and lung tissues were dissected, extracted, and frozen prior to measurement of all-trans-RA concentration by high-performance liquid chromatography (HPLC). Aerosolization and IT injection of all-trans-RA resulted in a significantly longer pulmonary half-life of the drug (both 5-17 h), lower peak serum concentrations (aerosol 71 +/- 31 ng/ml, IT 68 +/- 50 ng/ml), and lower liver levels (aerosol 111 +/- 28 ng/g, IT 753 +/- 350 ng/g) than the same dose administered IV (2 h, 838 +/- 56 ng/ml, 4,258 +/- 1,006 ng/g, respectively; P < 0.05 for each comparison). Histologic examination of lungs and trachea showed no focal irritation attributable to the drug after single-dose administration. These results suggest that aerosolization of retinoids may offer a practical alternative to systemic oral administration for chemoprevention trials or treatment of lung diseases. This method may substantially increase the therapeutic index of these compounds by reducing systemic complications associated with long-term dosing.

Administration, Inhalation↗
PubMed1999

Aerosol delivery of liposomal all-trans-retinoic acid to the lungs.

PURPOSE: To optimize the delivery of all-trans-retinoic acid (ATRA) to lung tissue, we determined the potential of vehiculating the drug in liposomes (L-ATRA) and delivering it via aerosol. Liposomes may provide a means to prevent local irritation of lung tissue and reduce pulmonary toxicity, prolong therapeutic levels and generate high drug concentrations at the tumor sites. Cumulatively, this would result in reduced systemic toxicity and enhanced drug efficacy. METHODS: Previous studies have shown that liposomes can serve as excellent carriers for otherwise poorly soluble ATRA. Delivery of ATRA to the lung tissue of mice was accomplished by nebulization of L-ATRA. The liposomes in the aerosol were relatively uniform (309 +/- 138 nm), stable, and retained the drug well. RESULTS: The drug was effectively delivered at high concentrations (10 +/- 2 microg/g of tissue) to the lungs of mice and was retained for at least up to 96 h after a single exposure to L-ATRA aerosol. No appreciable levels of ATRA were detected in the blood or the liver of treated mice. The aerosol-delivered ATRA was biologically active as demonstrated by its ability to induce the expression of tissue-type transglutaminase. CONCLUSION: Aerosol delivery of L-ATRA offers an effective way to deliver high levels of ATRA to the lung without apparent pulmonary toxic effects.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed1999

Distribution of camptothecin after delivery as a liposome aerosol or following intramuscular injection in mice.

PURPOSE: The plant alkaloid camptothecin (CPT) has shown significant antitumor activity against a wide variety of human tumors xenografted in nude mice. In previous studies we have found that administration of dilauroylphosphatidylcholine (DLPC) liposome aerosols containing 9-nitrocamptothecin (9-NC) inhibits the growth of human breast, colon and lung cancer xenografts. The purpose of this study was to analyze the pharmacokinetics and tissue distribution of inhaled CPT formulated in DLPC liposomes. METHODS: C57BL/6 mice with subcutaneous Lewis lung carcinoma, Swiss nu/nu mice with human lung carcinoma xenografts and BALB/c mice without tumors were used for pharmacokinetic studies of CPT administered as a liposome aerosol and BALB/c mice were given CPT intramuscularly. RESULTS: After 30 min inhalation of CPT liposome aerosol, drug was deposited in the lungs (310 ng/g) and was followed promptly by the appearance of high concentrations in the liver (192 ng/g) and with lesser amounts appearing in other organs. Drug concentration in the brain was 61 ng/g. After intramuscular injection of CPT dissolved in DMSO, drug was released from the site of injection very slowly and accumulated mainly in the liver (136 ng/g). Only trace amounts appeared in the lungs (2-4 ng/g). These results demonstrate a prompt pulmonary and later systemic distribution of CPT following liposome aerosol administration. CONCLUSIONS: The substantial concentrations of CPT in lungs and other organs following inhalation of liposome aerosol suggest the possible benefit of it and of its more active derivative, 9-NC, in the treatment of lung, liver, kidney and brain cancer in humans.

Aerosols↗
PubMed2006

Intraperitoneal aerosolization of bupivacaine reduces postoperative pain in laparoscopic surgery: a randomized prospective controlled double-blinded clinical trial.

BACKGROUND: Laparoscopic strategies for managing intraabdominal pathologies offer significant benefits compared with conventional approaches. Of interest are reports of decreased postoperative pain, resulting in shorter hospitalization and earlier return to normal activity. However, many patients still require strong analgesia postoperatively. This study analyzed the use of intraoperatively delivered aerosolized intraperitoneal bupivacaine and its ability to reduce postoperative pain. METHODS: For this study, 80 patients undergoing laparoscopic cholecystectomy were recruited and divided randomly into four groups: control (n = 20), aerosolized bupivacaine (n = 20), aerosolized normal saline (n = 20), and local bupivacaine in the bladder bed (n = 20). All the patients had standard preoperative, intraoperative, and postoperative care. Pain scores were recorded by the nursing staff in recovery, then 6, 12, and 24 h postoperatively using a standard 0 to 10 pain scoring scale. In addition, opiate consumption and oral analgesia were recorded. RESULTS: Aerosolized bupivacaine significantly reduced postoperative pain in comparison with all other treatments (p < 0.05). Injection of bupivacaine into the gallbladder bed did not result in a significant difference from the control condition. CONCLUSION: Aerosolized intraperitoneal local anesthetic is an effective method for controlling postoperative pain. It significantly helped to reduce opiate use and contributed to rapid mobilization, leading to short hospitalization and possible reduction in treatment cost.

Adult↗
PubMed2006

Comparison of EC and BC and evaluation of dust aerosol contribution to light absorption in Xi'an, China.

The concentrations of EC, BC and dust aerosols were determined for atmospheric samples collected from an observation station in Xi'an, China. The results show that the averaged correlation coefficient between EC and BC was founded to be 0.72 with 0.81 (n = 49) in autumn, 0.70 (n = 112) in winter and 0.69 (n = 57) in spring, respectively. Absorption coefficients of dust aerosol were estimated to be 2.7 m(2) g(-1) in autumn and 4.4 m(2) g(-1) in winter. The comparison of absorption coefficients of dust aerosol with those of BC implies that BC is the principal light-absorbing aerosol over Xi'an atmosphere. By combining thermal analysis of elemental carbon and dust contents in the aerosol samples, however, the fraction of dust absorption to total light absorption is estimated to be 19% in autumn and 31% in winter, respectively.

Aerosols↗
PubMed2004

Aerosol profile extracted from spacers as a determinant of actual dose.

PURPOSE: We propose a novel method to evaluate the efficacy of a pressurized metered dose inhaler (pMDI) in combination with a spacer, by not only considering the total dose extractable from the spacer but also the dependence of dose on the volume available for aerosol inhalation. METHODS: We studied volume-dependence of aerosol concentration during extraction from two commonly used plastic spacers (150 ml AerochamberPlus; 750 ml Volumatic) after a single puff of a 100 microg salbutamol pMDI (HFA-Ventolin), using laser photometric measurements. RESULTS: After a delay of is in each spacer, the aerosol peak dose for AerochamberPlus was 2-fold that for Volumatic (p < 0.001), with the peak appearing well within the first 0.5 L even for the largest spacer. The opposite dose relationship is reached when considering total cumulative dose, which was 2-fold higher for Volumatic than for AerochamberPlus (p < 0.001); >95% of total cumulative dose was extracted well within 3 L for the largest spacer. The 2-fold cumulative dose relationship was confirmed by chemical assay on an absolute filter [AerochamberPlus: 21.4+/-3.2 (SD) microg; Volumatic: 43.8+/-9.1 (SD) microg]. CONCLUSIONS: Actual aerosol dose available to patients during inhalation via spacers can only be done on the basis of a quantification of aerosol peak dose and cumulative dose as a function of extracted volume.

Administration, Inhalation↗
PubMed1996

Theoretical relationship of lung deposition to the fine particle fraction of inhalation aerosols.

Pharmaceutical inhalation aerosols intended to deliver drugs to the lungs may be sampled by inertial devices, that divide particle distributions into pre-calibrated diameters. A characteristic particle diameter (D50) is prescribed, below which the aerosol mass is designated the 'respirable fraction'. The following studies compare designated respirable fractions with predicted lower lung deposition. Designated respirable fractions (% of particulate matter < 6.4 microns or alternatively < 9.8 microns) of 30, 40 and 50% were selected to represent typical inhalation aerosols. The compendial inertial samplers used to aerodynamically characterize the particle size of pharmaceutical aerosols operate at approximately 30 or 60 l/min. These values were selected as the volumetric flow rates (Qv) for a mathematical model of lung deposition. The model was employed to predict the lung deposition of particle size distributions giving rise to each designated respirable fraction. Nominal tidal volumes (Tv) of 500 and 1622 ml were adopted at appropriate breathing frequencies to accommodate the designated Qv. Predicted lung depositions (+/- range due to particle size) of 1.4 +/- 0.6%, at a respirable fraction of 30% (Qv = 60 l/min, Tv = 500 ml, D50 = 9.8 microns), and 20.9 +/- 3.6%, at a respirable fraction of 50% (Qv = 30 l/min., Tv = 1622 ml, D50 = 6.4 microns) illustrate the range of results obtained. Under well defined conditions there appeared to be a qualitative correlation between respirable fraction and predicted lower lung deposition. However, this was influenced by the aerosol particle size distribution and breathing parameters.

Aerosols↗
PubMed1982

Inhaled lidocaine aerosol changes resting human breathing pattern.

We compared resting breathing patterns in twelve normal humans before and after administration of aerosols of normal saline and 4% lidocaine. Experiments were performed in random order on two consecutive days in single blind fashion. At the time of the experiments, neither the subjects nor the people who analyzed the results knew the purpose of the study. Neither saline nor lidocaine aerosols produced changes in FEV1.0 or end-tidal PCO2, or, in the six subjects in whom measurements were made, changes in functional residual capacity or airway resistance. Aerosols of normal saline produced no change of ventilation (VI), breathing frequency (f), tidal volume (VT), duration of inspiration (Ti), mean inspiratory flow (VT/Ti) or the fraction of the breathing cycle devoted to inspiration (Ti/Tt). Lidocaine aerosols, on the other hand, were associated with a decrease in f (P less than 0.01), an increase in Ti (P less than 0.01), an increase in VT (P less than 0.02) and a decrease in VI (P less than 0.05), while VT/Ti and Ti/Tt were unchanged. We conclude that lidocaine aerosols, by compromising the function of vagal airway receptors, altered breathing pattern in normal resting humans, indicating that these receptors play a role in regulating breathing pattern under these circumstances. Though the changes we observed are most simply explained as being due to decreased stretch receptor activity, we cannot be certain that such was the case.

Adult↗
PubMed1983

Pulmonary toxicity of inhaled coal liquid aerosols (boiling range 230-450 degrees C).

The biological activity of materials produced in the direct liquefaction of coal is being assessed by a variety of test systems. In this study, the pulmonary toxicity of process solvent (PS) from the solvent refined coal-I (SRC-I) process was determined by histamine aerosol challenge tests and pulmonary function and morphologic evaluations. Guinea pigs inhaled aerosols of PS (boiling range, 230 to 450 degrees C) for 6 hr/day, 5 day/week, for up to 12 days in three different experiments. In the first experiment, 8-week-old animals inhaled 0 (controls), 0.15, or 0.60 mg/liter PS aerosols with a mass median aerodynamic diameter (MMAD) of 1.3 micrometer. Exposure to 0.15 mg/liter PS for 12 days resulted in depressed weight gain and marked hypersensitivity to inhaled histamine compared with sham-exposed control animals. Four of five animals exposed to 0.6 mg/liter PS died of respiratory failure during exposure. During the second experiment, 14-week-old animals inhaled 0 (controls) or 0.19 mg/liter PS (MMAD, 1.3 microns) for 1, 3, or 12 days. Hypersensitivity to aerosolized histamine occurred only after 12 days exposure to PS aerosols. At that time, morphologic lung evaluations showed mild to moderate pneumonitis and accumulation of exudate in bronchioles of PS-exposed animals. In the third experiment, pulmonary function evaluations were conducted on 4-week-old animals exposed to 0 (controls) or 0.19 mg/liter PS for 8 days. Functional changes measured in these animals (compared to controls) included increased gas trapping at low lung volumes, decreased quasi-static compliance, and decreased diffusion capacity of the lung for carbon monoxide. These studies showed that measurable changes in lung function were produced in guinea pigs after 8 to 12 days exposure to 0.15 or 0.19 mg/liter PS and that exposure to PS affected weight gain only in younger animals (4 and 8 weeks old) but not in 14-week-old animals.

Aerosols↗
PubMed1992

Aerosols characterization in a forested site in Québec, Canada.

Three AERAS low pressure 11 stage cascade impactors with rotatable collecting plates (LPCR) were installed at the Duchesnay forest station near Québec City and four low pressure inertial collectors (LPIC) were installed in the forest. The analysis of the aerosol deposits was performed by static fast atom beam mass spectroscopy (FABMS); SIMS and ESCA analyses were also made. The morphological characterization and the elemental volumetric composition of the aerosols were established by a scanning electron microscope equipped with an X-ray dispersive energy analyser. Micro-weighting of the aluminium substrate before and after the sampling by the AERAS impactor enabled the study of the mass-size-distribution of the aerosols according to their aerodynamic equivalent diameter. Example of the results obtained are presented in relation to air parcels' trajectories. This study has shown that it is possible to characterize the aerosols according to the origin and trajectories of the air mass with which they travel; sources along the tracks have been shown to contribute to the aerosol loading of the air masses.

Aerosols↗
PubMed1977

Oropharyngeal candidiasis in patients treated with triamcinolone acetonide aerosol.

Thirty asthmatic patients participating in a trial of triamcinolone acetonide aerosol were evaluated to determine the relationships among symptons of sore throat or hoarseness, the appearance of the throat on physical examination, and the presence of yeasts on pharyngeal culture. Observations were recorded prior to aerosol therapy and repeated after 2 wk, 4 wk, 6 wk, 4 mo, and 6 mo of therapy. A total of 15 patients (50%) experienced sore throat or hoarseness, 15 (50%) had yeasts cultured from the pharynx on at least one occasion, and 11 (37%) at some point had an abnormal throat examination; however, there was no predictable relationship between symptoms or abnormal physical examinations and the presence of a positive culture. The frequency of positive cultures did not change significantly during the observation period. Twelve patients had positive yeast cultures on 50% or more of their samples. The incidence of symptoms was not sigficantly increased in these chronically colonized patients. Symptoms were usually transient, and discontinuation of the aerosol or antifungal therapy was unnecessary. Triamcinolone aerosol was not associated with significantly increased pharyngeal colonization with yeasts in this 6-mo study. Existing chronic colonization is not necessarily a contraindication to triamcinolone therapy. Sore throat and hoarseness are usually unrelated to yeast infection in patients using triamcinolone acetonide aerosol.

Adult↗
PubMed1982

Development of chronic pulmonary inflammation in immunized guinea pigs by aerosol challenge with antigen: relationship of immune complex disease and cell-mediated hypersensitivity.

Immunized guinea pigs develop immune complex disease (ICD) in the lungs after a single aerosol challenge with specific antigen. In the current study, immunized guinea pigs developed chronic pulmonary inflammation and cellular immunity (CI) in the lungs when aerosol challenged daily with specific antigen for 2 wk. When immune serum was passively transferred to normal recipients that were then aerosol challenged with specific antigen for 2 wk, chronic pulmonary inflammation and CI did not develop. These results suggest that ICD produced by passive transfer of serum and subsequent aerosol exposure to antigen was inadequate to cause chronic pulmonary inflammation and CI. The development of chronic pulmonary inflammation by aerosol challenge with antigen was suppresed with cobra venom factor. However, because of other studies, we attribute this suppression to the diminution of complement (C) factors in the alternative C pathway that affect macrophage mobility rather than to the depletion of C5a, which is important in the development of ICD.

Aerosols↗
PubMed1985

Bitolterol and albuterol metered-dose aerosols: comparison of two long-acting beta 2-adrenergic bronchodilators for treatment of asthma.

In this double-blind, parallel, single-dose study, bitolterol mesylate aerosol (three sprays, 1.11 mg) and albuterol aerosol (two sprays, 180 mcg) were compared for efficacy of bronchodilation in 120 adolescent and young adult patients with moderate to severe asthma. All patients required regular medications for asthma control. None was steroid dependent. Both medications gave effective bronchodilation within 5 min with maximum effect at 30 to 60 min. Mean percent increase in forced expiratory volume in 1 sec (FEV1) over baseline was higher for bitolterol than for albuterol at all test times up to 8 hr after a dose at which time 20% mean percent increase of FEV1 over baseline was still present in the bitolterol-treated patients. With albuterol mean percent increase in FEV1 fell to 15% over baseline at 5 hr after a dose. Differences in FEV1 increase between the two treatment groups were statistically significant at 4 to 8 hr after a dose. Patients with baseline FEV1 less than 50% of predicted normal had a response to bitolterol that was higher than that observed with albuterol treatment (p less than 0.1). Mean maximum percent increase in FEV1 and median duration of bronchodilation were greater with bitolterol than with albuterol, but the differences were not statistically significant. Both bitolterol aerosol and albuterol aerosol were demonstrated to be safe, effective, and long-acting bronchodilating agents. Both bitolterol and albuterol administered by aerosol had a rapid onset, and the maximum degree of bronchodilation was comparable. However, at the doses studied, bitolterol produced significantly higher increase in FEV1 over baseline at longer times after medication than did albuterol.

Adolescent↗
PubMed1987

Comparison of inhaled albuterol powder and aerosol in asthma.

In this multicenter, randomized, double-blind study comparing the efficacy and safety of aerosolized albuterol with the dry powder formulation, 231 patients with chronic reversible obstructive airway disease were randomly allocated to receive either placebo albuterol aerosol followed immediately by active albuterol powder (200 micrograms) or active albuterol aerosol (two puffs, 180 micrograms) followed immediately by placebo lactose powder four times a day for a period of 12 weeks. No statistically significant differences were found between the powder and aerosol formulations with respect to pulmonary function, length of time mean FEV1 remained greater than or equal to 15% above baseline, physicians' assessments of patients' clinical response, or patients' subjective symptom scores. There were also no significant differences between treatment groups in cardiovascular effects, laboratory values, or adverse events. Among patients who expressed a preference for one of the delivery systems, half preferred using the powder. Results of this study demonstrate that 200 micrograms of albuterol powder is as safe and effective as 180 micrograms of albuterol aerosol.

Administration, Inhalation↗
PubMed1988

Twelve-hour bronchodilation in asthma with a single aerosol dose of the anticholinergic compound glycopyrrolate.

Anticholinergic aerosols provide effective bronchodilation in some patients with obstructive lung disease. Glycopyrrolate is a quaternary ammonium anticholinergic compound that is poorly absorbed from mucus membranes, thus reducing anticholinergic side effects. In 20 adult patients with asthma, we evaluated bronchodilation to a single administration of metered-dose glycopyrrolate aerosol (GA) to ascertain its onset and duration of action along with evaluation of safety. In this randomized, double-blind, placebo-controlled, single-dose, crossover trial, bronchodilation was evaluated on five separate occasions to either placebo or a GA dose of 80, 240, 480, or 960 micrograms. Baseline spirometry for each patient on each visit was similar (mean FEV1 +/- SD of 62.2 +/- 13.6% predicted). After aerosol dosing, spirometry was measured at 30 minutes and then at hourly intervals up to 12 hours. Compared to placebo, metered-dose aerosols of 240, 480 and 960 micrograms elicited significantly greater bronchodilation at each test time. Furthermore, significant bronchodilation was noted within 30 minutes of dosing and was sustained for at least 12 hours. Bronchodilation with the 480 and 960 micrograms dose was equal, and both were greater than 240 micrograms. A subset of four asthma patients with baseline FEV1 values less than 50% predicted did not have a bronchodilating response with GA. No notable side effects occurred. Thus, a single aerosol dose of GA provides clinically significant, safe 12-hour bronchodilation in patients with asthma without severe airway obstruction (i.e., FEV1 greater than 50% predicted).

Adult↗
PubMed1989

Albuterol treatment for children with asthma: a comparison of inhaled powder and aerosol.

A dose-ranging study and a 12-week treatment study were conducted in children with asthma, aged 4 to 12 years, to assess the efficacy and safety of albuterol inhaled as either an aerosol or as dry powder. Both studies were double-blind and placebo-controlled with randomized assignment to treatment. The dose-ranging study in 30 patients indicated that similar single doses of albuterol aerosol and powder had comparable effects with the intermediate doses (i.e., 180 micrograms of aerosol and 200 micrograms of powder) providing effective bronchodilation with minimal adverse effects. In the subsequent 12-week, parallel-group study, 204 children received albuterol as either aerosol, 180 micrograms, or powder, 200 micrograms four times a day. Both formulations were equally effective with no untoward cardiovascular effects and only one incident of mild tremor. Among those children who expressed a preference for one of the delivery systems, significantly more children preferred the powder (44% versus 26%, p less than 0.01). Albuterol taken four times a day as either aerosol or dry powder is both effective and well tolerated in children with asthma.

Administration, Inhalation↗